Saudi Journal of Kidney Diseases and Transplantation

LETTER TO THE EDITOR
Year
: 2013  |  Volume : 24  |  Issue : 6  |  Page : 1248--1249

Cytomegalovirus infection following renal transplantation: An analysis of 21 cases in an endemic area


Beuy Joob1, Viroj Wiwanitkit2,  
1 Sanitation 1 Medical Academic Center, Bangkhae, Bangkok, Thailand
2 Wiwanitkit House, Bangkhae, Bangkok, Thailand

Correspondence Address:
Beuy Joob
Sanitation 1 Medical Academic Center, Bangkhae, Bangkok
Thailand




How to cite this article:
Joob B, Wiwanitkit V. Cytomegalovirus infection following renal transplantation: An analysis of 21 cases in an endemic area.Saudi J Kidney Dis Transpl 2013;24:1248-1249


How to cite this URL:
Joob B, Wiwanitkit V. Cytomegalovirus infection following renal transplantation: An analysis of 21 cases in an endemic area. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2021 Apr 20 ];24:1248-1249
Available from: https://www.sjkdt.org/text.asp?2013/24/6/1248/121290


Full Text

To the Editor,

An important problem in renal transplant recipients is the development of infection. Infections in this group of patients can be severe and fatal. Appropriate screening of the donor and recipient, drug prophylaxis, and good infection control seem to be the key factors in preventive management. Of the several infections that can occur in renal transplant recipients, cytomegalovirus (CMV) infection is important. [1] We herein briefly summarize and discuss the case reports published on CMV infection in renal transplant recipients in Thailand, a country endemic for this infection. We performed a literature search using standard database (PubMed) and local reference database (Thai Index Medicus), with the key words "transplantation," "kidney," and "cytomegalovirus." The derived publications with the details on the renal transplant recipients were used for summative analysis. Based on the search, three publications were analyzed. [2],[3],[4] These publications covered 21 indexed cases (11 males and 10 females, aged between 41 and 56 years). Pre-transplant serological data were available in 20 cases. The donor serology revealed that all 20 cases were CMV sero-positive (100%) and the recipient serology revealed CMV seropositivity in 18 cases (90%). All the study patients received the immunosuppressive drug cyclosporine. The clinical presentation in all cases was fever with urinary tract infection; one case had bloody diarrhea in addition. The incubation period of the infection was between seven weeks and seven months. All the patients were treated with the drug ganciclovir. Following treatment, complete recovery was seen in 17 cases and allograft rejection and death occurred in one case each.

A recent report has confirmed that the problem of latent CMV infection among renal transplant recipients is very important and could result in graft rejection and death. [5] It has been proved that the infection is an independent risk factor for graft rejection. [5] Based on this work, it could be seen that the seropositivity among the donors was 100%, indicating the endemicity of the disease. Hence, proper donor selection might be the clue for prevention of CMV infection. Focusing on the recipient, pre-transplant screening will be helpful in identification of the sero-negative cases who could be the target group for close monitoring and use of drug prophylaxis.

References

1Rostaing L, Wéclawiak H, Mengelle C, Kamar N. Viral infections after kidney transplantation. Minerva Urol Nefrol 2011;63:59-71.
2Sookpranee M, Premyothin P, Jarusiripipat C, Supasiti T. Persistent fever after urinary tract infection in a renal recipient. J Infect Dis Antimicrob Agents 1994;1:133-6.
3Nayudhaya DP, Praditpornsilpa K, Tewthanom K. The Incidence of cytomegalovirus infection in renal transplant patients: Single center study. Thai J Pharm Sci 2003;27 Suppl:42.
4Nayudhaya DP, Praditpornsilpa K, Tewthanom K. The Incidence of cytomegalovirus infection in renal transplant patients: Single center study. Chula Med J 2004;48:343-55.
5van Ree RM, de Vries AP, Zelle DM, et al. Latent cytomegalovirus infection is an independent risk factor for late graft failure in renal transplant recipients. Med Sci Monit 2011; 17:CR609-17.